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9803-012 (RER)U F- N U) W o5Ch r`d� ' W o Z ti C.6 O O CO Fa Z M LO N ON U °) Q ,It IL Z ��CC O X W �= O_JQ mUU O QMH "I- Z_ CS 5 r` d J LICENSED CONTRACTOR_ DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 674074- 14 �f3 Date it/rSignature of Contractor I OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ( ) 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business & Professionals Code). ( ) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business & Professionals Code). ( ) I am exempt under Section , B&P.C. for this reason Date Signature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ( ) I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. (A) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier & policy no. are: Carrier Policy No. STATE VIAND 1-1710959", (This section need not be completed if the permit valuation is for $100.00 or less). ( ) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become sybject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. i15ate: ' . % 11'f' ^ Applicant Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant to any permit issued as a result of this applicaton agrees to, & shall; indemnify & hold harmless the City of La Quinta, its officers, agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. 1 VV t let )Signature (Owner/Agent) `---`�^^-- Date ' 4 el BUILDING PERMIT PERMIT# CONTROL# ��tli3-!}il 7 DATEVALUATION ",�r�� LOT TRACT 6909 JOB SITE ADDRESS 79-42S 8.KL,%, )(301) APN OWNER( CONTRACTOR / DESIGNER / ENGINEER ��i p T.1>.1iL�:7iRii'e SPARKSCIOAx�s P.O. BO:, 11716 79295 RANCHO grit QI.iOrlA1. DR. LA,Qtltty'-M CA. M.53 f.r1QUINTA CA 92253 (760)171-1941 C'Ilfl 2996 USE OF PERMIT CiUIw vi�2T .i� E2tr �: i I ;ulnad T, o uaiwty' aukti Jti:t NG .t?,ATH: MA MA 10 1998 AI;Ul4'f ON, 0,000.0+3I...; ,CITY O LA QUi NTA �� •i3: F.wsaTiN!A'",,P COST or, CONSIT91It'3ION ��,�ii99f.8#ti PERMIT V CC, SUMMARY PLAN'14ErCX? FEE 101-ON41W-M8 S760 o,NSTRTfrMlONFEE f0t-W41 84M Sf1; (W) L L1KC1Vk1C4%1. 104 10 1 _000-4210 _000 a'1'RONG MOTION - RES11) 1Qi-wo.'24i.-t7i!(? Sl.t+G USS pill "'N T4A RECEIPT DATE BY' DATE FINALED INSPECTOR INSPECTION RECORD OPERATION DATE INSPECTOR OPERATION DATE INSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Combustion Air Roof Deck Exhaust Fans O.K. to Wrap F.A.U. Framing . 6 Compressor Insulation Vents Fireplace P.L. Grills Fireplace T.O. Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lath Final Final BLOCKWALL APPROVALS POOLS - SPAS steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping - PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection Encapsulation Gas Piping Gas Test Appliances Final Final Utility Notice (Gas) ELECTRICAL APPROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power t l Final Utility Notice (Perm) COMMENTS: Bi" #2 " City of La Quinta. q BuildingU Safe Division Safety p, P.O. Box 1504, 78-495 Calle Tampico La Quinta, CA 92253 - (760) 777-7012 ..Building -Permit Application and TrackinSheet pP g Permit# '^ a �2 Project Address: W• rj ?3.4+Rkjap' ' Owner's Name: Ti¢.✓ iV 7' A. P. Number: Address: o a Legal Description: City, ST, Zip: L�¢ µ ,,, 7 Z Z C Contractor: VO v �/ �-� r Address:'g Project Description: �•TlG �� A City, ST, Zip: 927-0 Telephone: �6Q� �' D ,• 7T State Lic. # : q So Z City Lic. #: Arch., Engr., Designer: QVS0 V Opo Address: -71V City, ST, Zip -T .� � © : Telephone:'W qo,?— .Q r State Lic. #: Construction Type: wa#p Occupancy: Project type (circle one): New ' Add' Alter Repair Demo . l Name of Contact Person: �.i�Mp/V Sq. FL: 5� # Stories: #Units: Telephone # of Contact Person: Estimated Value of Project: APPLICANT. DO NOT WRITE BELOW THIS UNE l Req'd Recd TRACING . PERMIT FEES F Plan Check submitted Z Item Amount l Calcs. Reviewed, rea for corrections Plan Check. Deposit lcs. Called Contact Person (S Plan Check Balance Energy Cales. Plans picked up Construction Flood plain plan Plans resubmitted Mechanical Grading plan 2°' Review, ready for corrections!'issue Electrical Subcontactor List Called Contact Person Plumbing Grant Deed Plans picked up S.M.I. t fi.O.A. Approval Plans resubmitted Grading IN HOUSE:- ''' Review, ready for correction4 Developer Impact Fee Planning Approval Called Contact Person 0 J.P.P. Pub. Wks. Appr Date of permit issue School Fees Total Permit Fees Coronado Design Group 74-854 Velie Way Stuite 8 Palm Desert, CA 92260 (760) 480-0972 CITY OF LA QUINTA PLAN CHECK CORRECTION LIST PLAN CHECK NO. 07-2263 ADDRESS 79-425 Briarwood SCOPE OF WORK Covered Patio August 15, 2007 FIRST CHECK/APPROVED (Structural) OCCUPANCY R -3/U-1 TYPE -OF -CONST. V -N The submitted plans and specifications have been reviewed by the VCA CODE GROUP. In our professional opinion the plans are in substantial conformance with the building codes and regulations adopted by the CITY OF LA QUINTA and the State of California Amendment. APPROVAL FOR A BUILDING PERMIT IS HEREBY RECOMMENDED SUBJECT TO OBTAINING APPROVALS/CLEARANCES FROM ALL APPLICABLE CITY DEPARTMENTS, AGENCIES, AND ASSOCIATIONS. Plans checked by: Perry 4astopoulos, PE VCA CODE GROUP 2200 W. Orangewood Avenue, Suite 155 , Orange, CA 92868 (714) 363-4700 VCA File No. LQ -20158 1